First, although the deadly illness is often referred to as the Spanish flu, it likely did not originate in Spain. Although the exact source of the virus has not been found, historians believe that someone from Kansas carried the flu to an Army base there, where it quickly spread, in the spring of 1918. American soldiers then carried it to Europe as they were shipped there during World War I. American soldiers brought a more virulent version of the flu back to America, with large outbreaks in port cities where large numbers of troops were welcomed home.
The first wave, in the spring of 1918, was not particularly lethal with many people recovering within three days. But, in the autumn of 1918, the flu had become much more virulent and the mortality rate associated with the illness during this second wave was staggering. In October alone, 195.000 people in America alone died from the flu.
One of the most important things to know about the 1918 flu is that it was not a one-time event. There were Three waves of the illness, and the second and third waves were more deadly than the first.
A third wave began in Australia in early 1919 and the flu again made its way around the world. This wave was not as deadly as the second, but caused more deaths than the first.
All told, more than 50 million people died from the outbreak and a third of the world’s population was infected.
Another crucial lesson to keep in mind is that physical distancing and stay-at-home orders work, and should be lifted carefully based on data, not political pressure.
Researchers who have studied the 1918 flu conclude that states and cities in the USA that followed public health recommendations about how the disease spread generally had fewer deaths than those that did not. San Francisco, for example, was the first city to order a lockdown and its health director urged residents to wear masks. The city was spared from high death rates in the first and second rounds, but not the third.
Officials in Philadelphia, along with federal officials, downplayed the severity of the illness. Rather than implement social distancing protocols, as many cities did, Philadelphia held a large victory parade in late September 1918. Within weeks, 4,500 people had died in the city.
“Thinking that the proverbial coast was clear, many communities lifted social distancing measures before the battle was truly over,”
“After weeks of being denied their usual social outlets, people were eager to return to a life of normalcy, and they did so in one giant rush. In city after city, masses lined up for cinemas and theatres, crowds packed into dance halls and cabarets, and throngs flocked to down town shopping districts, often on the very day that the closure orders were lifted.
“The result? Cases and deaths resurged,” !!!
The 1918 influenza pandemic was the most severe pandemic in recent history. It was caused by an H1N1 virus with genes of avian origin. Although there is not universal consensus regarding where the virus originated, it spread worldwide during 1918-1919. In the United States, it was first identified in military personnel in spring 1918. It is estimated that about 500 million people or one-third of the world’s population became infected with this virus. The number of deaths was estimated to be at least 50 million worldwide with about 675,000 occurring in the United States.
Mortality was high in people younger than 5 years old, 20-40 years old, and 65 years and older. The high mortality in healthy people, including those in the 20-40 year age group, was a unique feature of this pandemic. While the 1918 H1N1 virus has been synthesized and evaluated, the properties that made it so devastating are not well understood. With no vaccine to protect against influenza infection and no antibiotics to treat secondary bacterial infections that can be associated with influenza infections, control efforts worldwide were limited to non-pharmaceutical interventions such as isolation, quarantine, good personal hygiene, use of disinfectants, and limitations of public gatherings, which were applied unevenly.
https://www.cdc.gov/flu/pandemic-resources/1918-pandemic-h1n1.html
Additional Resources
- The Deadliest Flu: The Complete Story of the Discovery and Reconstruction of the 1918 Pandemic Virus
- 1918 Pandemic Flu Partner Webinar
- Pandemic Influenza Storybook
- The Deadly Virus: The Influenza Epidemic of 1918external icon
- Pandemic Influenza—Past, Present, Future: Communicating Today Based on the Lessons from the 1918-1919 Influenza Pandemic pdf icon[1.72 MB, 47 Pages]
- Influenza of 1918 (Spanish Flu) and the U.S. Navyexternal icon
- Glezen WP. Emerging infections: pandemic influenza. Epidemiol Rev. 1996;18(1):64-76.external icon
- Kilbourne ED. Influenza pandemics of the 20th century. Emerg Infect Dis. 2006 Jan;12(1):9-14.external icon
- Taubenberger JK, Morens DM 1918 influenza: the mother of all pandemics. Emerg Infect Dis. 2006;12:15–22
- Belser, JA ; Tumpey, TM. The 1918 flu, 100 years later: Science. 2018 Jan. Vol. 359, Issue 6373, pp. 255external icon
- Jester, B; Uyeki, T; Jernigan, D. Readiness for Responding to a Severe Pandemic 100 Years After 1918: American Journal of Epidemiology. 2018, Jan.external icon
